Subtypes of Alcohol Expectancies Are Differentially Associated With Alcohol Use for Bisexual and Heterosexual Women.

Background: Bisexual women, compared to heterosexual women, report greater amounts of alcohol use and heavy drinking. Alcohol expectancies (i.e., beliefs about alcohol outcomes) are a strong predictor of alcohol use, but few studies have examined the importance of alcohol expectancies in relation to alcohol use among bisexual women specifically or in comparison to heterosexual women. Objectives: The current study examined 262 heterosexual and 225 bisexual women using an online survey about alcohol use, sexual risk-taking, and alcohol expectancy subtypes (sexuality, tension reduction, and aggression). Results: Compared to heterosexual women, bisexual women reported greater sexuality and tension reduction expectancies after accounting for their level of drinking, but groups did not differ on aggression expectancies. Moreover, sexual identity status moderated the associations between sexuality and tension reduction expectancies and alcohol use, respectively. Specifically, our study findings suggested that sexuality and tension reduction alcohol expectancies were more strongly tied to alcohol use among bisexual women than heterosexual women. Conclusions: Taken together, in our study, bisexual women held stronger sexuality and tension reduction expectancies, as compared to heterosexual women. Interventions targeting alcohol expectancies may be considered when tailoring intervention content for this population.

Latent profiles of impulsivity facets and associations with drinking behaviors.

BACKGROUND: Impulsivity is positively associated with alcohol use. However, scant research has used person-centered approaches to examine how patterns of impulsivity facets may be associated with alcohol-related outcomes. Consequently, the present study sought to (1) identify latent groups of individuals who share similarities based on the five facets of impulsivity assessed using the UPPS-P scale (positive urgency, negative urgency, premeditation, perseverance, and sensation seeking) and (2) examine differences between latent profiles on alcohol use (i.e., typical alcohol quantity, typical alcohol frequency, binge frequency), alcohol consequences, and drinking motivations. METHODS: Participants were 360 (M age = 21.83; 78.9 % female; 49.4 % racial/ethnic minority) college students who reported weekly drinking over the prior 30 days. They completed questionnaires of impulsivity, alcohol use behaviors, alcohol consequences, and drinking motivations. Latent profile analysis was used to identify classes based on the five UPPS-P facets as indicators. RESULTS: Results revealed that three classes best fit the data: Highest UPPS-P (14.4 %); Moderate UPPS-P (56.9 %); and Lowest UPPS-P (28.6 %). Profiles did not vary on drinking behaviors (quantity, frequency, or binge frequency), but significant differences were observed on alcohol consequences and drinking motivations, specifically coping and conformity motives. CONCLUSIONS: Our data demonstrated that UPPS-P facets tend to cluster together, and patterns may pose risk for consequences and negative motives for drinking. The current study contributed to the conceptualization of impulsivity by identifying specific impulsivity typologies that may be used to target individuals at elevated risk for alcohol consequences.

Understanding the distinct experience of rural interprofessional collaboration in developing palliative care programs.

INTRODUCTION: Palliative care is one component of rural generalist practice that requires interprofessional collaboration (IPC) amongst practitioners. Previous research on developing rural palliative care has created a four-phase capacity development model that included interprofessional rural palliative care teams; however, the details of rural team dynamics had not been previously explored and defined. A growing body of literature has produced models for interprofessional collaborative practice and identified core competencies required by professionals to work within these contexts. An Ontario College of Family Physicians discussion paper identifies seven essential elements for successful IPC: responsibility and accountability, coordination, communication, cooperation, assertiveness, autonomy, and mutual trust and respect. Despite the fact that IPC may be well conceptualized in the literature, evidence to support the transferability of these elements into rural health care practice or rural palliative care practice is lacking. The purpose of this research is to bridge the knowledge gap that exists with respect to rural IPC, particularly in the context of developing rural palliative care. It examines the working operations of these teams and highlights the elements that are important to rural collaborative processes. METHODS: For the purpose of this qualitative study, naturalistic and ethnographic research strategies were employed to understand the experience of rural IPC in the context of rural palliative care team development. Purposive sampling was used to recruit key informants as participants who were members of rural palliative care teams. The seven elements of interprofessional collaboration, as outline above, provided a preliminary analytic framework to begin exploring the data. Analysis progressed using a process of interpretive description to embrace new ideas and conceptualizations that emerged from the patterns and themes of the rural health providers' narratives. The questions of particular interest that guided this work were: What are the collaborative processes of a rural palliative care team? To what extent are the seven elements of IPC representative of rural teams' experiences? Are there any additional elements present when examining the experiences of rural teams? RESULTS: The analysis showed that the seven identified elements of IPC were very much integrated in rural teams' collaborative practice, and thus validated the applicability of these elements in a rural context. However, all seven elements were implemented with a rural twist: the distinctiveness of the rural environment was observed in each element. In addition, another element, specific to rural context, was observed, that being the 'automatic teams' of rural practitioners - the collaboration has been established informally and almost automatically between rural practitioners. CONCLUSIONS: This research contributes new knowledge about rural palliative care team work that can assist in implementing models for rural palliative care that apply accepted elements of collaborative practice in the rural context. Understanding the process of how rural teams form and continue to function will help further the current understanding of IPC in the context in which these professionals work.

An aryl hydrocarbon receptor (AHR) homologue from the soft-shell clam, Mya arenaria: evidence that invertebrate AHR homologues lack 2,3,7,8-tetrachlorodibenzo-p-dioxin and beta-naphthoflavone binding.

The aryl hydrocarbon receptor (AHR) mediates numerous toxic effects following exposure of vertebrate animals to certain aromatic environmental contaminants, including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). To investigate possible effects of TCDD on invertebrates, a cDNA encoding an AHR homologue was cloned from the soft-shell clam, Mya arenaria. The predicted amino acid sequence contains regions characteristic of vertebrate AHRs: basic helix-loop-helix (bHLH) and PER-ARNT-SIM (PAS) domains and a glutamine-rich region. Phylogenetic analysis shows that the clam AHR sequence groups within the AHR subfamily of the bHLH-PAS family, in a clade containing AHR homologues from Drosophila melanogaster and Caenorhabditis elegans. AHR mRNA expression was detected in all tissue types tested: adductor muscle, digestive gland, foot, gill, gonad, mantle, and siphon. The in vitro-expressed clam AHR exhibited sequence-specific interactions with a mammalian xenobiotic response element (XRE). Velocity sedimentation analysis using either in vitro-expressed clam AHR or clam cytosolic proteins showed that this AHR homologue binds neither [(3)H]TCDD nor [(3)H]beta-naphthoflavone (BNF). Similarly, in vitro-expressed D. melanogaster and C. elegans AHR homologues lacked specific binding of these compounds. Thus, the absence of specific, high-affinity binding of the prototypical AHR ligands TCDD and BNF, is a property shared by known invertebrate AHR homologues, distinguishing them from vertebrate AHRs. Comparative studies of phylogenetically diverse organisms may help identify an endogenous ligand(s) and the physiological role(s) for this protein.

Expression of homologues for p53 and p73 in the softshell clam (Mya arenaria), a naturally-occurring model for human cancer.

Homologues for human p53 (Hsp53) and p73 (Hsp73) genes were cloned and expression patterns for their corresponding proteins analysed in tissues from normal and leukemic softshell clams (Mya arenaria). These are the first structural and functional data for p53 and p73 cDNAs and gene products in a naturally occurring, non-mammalian disease model. Core sequence of the predicted clam p53 (Map53) and p73 (Map73) proteins is virtually identical and includes the following highly conserved regions: the transcriptional activation domain (TAD), MDM2 binding site, ATM phosphorylation site, proline rich domain, DNA binding domains (DBDs) II-V, nuclear import and export signals and the tetramerization domain. The core sequence is a structural mosaic of the corresponding human proteins, with the TAD and DBDs resembling Hsp53 and Hsp73, respectively. This suggests that Map53 and Map73 proteins may function similarly to human proteins. Clam proteins have either a short (Map53) or long (Map73) C-terminal extension. These features suggest that Map53 and Map73 may be alternate splice variants of a p63/p73-like ancestral gene. Map73 is significantly upregulated in hemocytes and adductor muscle from leukemic clams. In leukemic hemocytes, both proteins are absent from the nucleus and sequestered in the cytoplasm. This observation suggests that a non-mutational p53/p73-dependent mechanism may be involved in the clam disease. Further studies of these gene products in clams may reveal p53/p73-related molecular mechanisms that are held in common with Burkitt's lymphoma or other human cancers.

Internalizing and externalizing behavior of children with enlisted Navy mothers experiencing military-induced separation.

OBJECTIVES: To examine whether children with Navy mothers exhibit higher levels of internalizing and externalizing behavior than children in civilian families and whether deployment affects children's internalizing and externalizing behavior. METHOD: Navy mothers who experienced deployment completed a measure assessing children's internalizing and externalizing behavior before and after a deployment (and at similar intervals for the Navy and civilian comparison groups). Data collection took place between 1996 and 1998. RESULTS: Navy children with deployed mothers exhibited higher levels of internalizing behavior than children with nondeployed Navy mothers. Navy children whose mothers experienced deployment were more likely to exhibit clinical levels of internalizing behavior than Navy children with nondeployed mothers or civilian children. Group differences, however, were modest and overall mean scores were in the normal range. CONCLUSIONS: Findings do not suggest greater pathology in children of Navy mothers; however, findings do indicate we should be particularly attentive of deployed mothers and their children.

Identification of an E3 ubiquitin-protein ligase in the softshell clam (Mya arenaria).

Softshell clams (Mya arenaria) were exposed to dioxin in controlled laboratory experiments in order to study their molecular response to dioxin exposure. A complementary DNA (cDNA) fragment with sequence similarity to E3 ubiquitin-protein ligase appeared to be upregulated in dioxin-exposed clams compared to controls. E3 covalently ligates ubiquitin onto a protein, targeting it for degradation. Our findings suggest that the ubiquitin-mediated proteolytic pathway in the softshell clam may be activated by dioxin exposure. Because the clam E3-predicted amino acid sequence is most similar to a specific vertebrate E3 protein (E6-AP), we hypothesize that dioxin may stimulate ubiquitin-mediated degradation of cell-cycle regulatory proteins, such as the tumor suppressor p53, which promotes cell proliferation. This pathway has been observed in human cervical cancer. Partial cDNA sequence of the clam E3 has been identified using the differential display polymerase chain reaction (ddPCR) and RACE (Rapid Amplification of cDNA Ends) PCR; the full-length sequence is currently being determined. Discovering the molecular mechanism(s) stimulated by dioxin exposure in this invertebrate model may contribute to a better understanding of the effects of dioxin on marine organisms.

Behavioral screening in well-child care: validation of the Toddler Behavior Screening Inventory.

OBJECTIVE: To provide additional normative and validity data on the TBSI, especially to examine differences in clinical and nonclinical samples. METHODS: The sample included 312 nonclinical and 50 clinical mothers of toddlers. Clinical participants consisted of mothers of toddlers who had been referred for outpatient psychological services. Mothers completed the TBSI, a 40-item behavioral screening measure for children 12 to 41 months old. The measure assesses frequency in which the behaviors occur and whether the mothers perceived the behaviors as problematic. In addition to the TBSI, mothers also completed several measures of maternal distress and social support. RESULTS: The findings support the reliability and validity of the TBSL. In addition, the study found that TBSI scores effectively discriminated clinical from nonclinical participants. CONCLUSIONS: The TBSI is a promising behavioral screening instrument that can be easily incorporated into a medical practice.

Communicating at life's end.

With more and more people choosing to die at home, palliative care is an increasingly important field. The challenge for those of us working in the field is to develop a comprehensive system of care that will provide high quality, in-home support. Such support involves a large network of formal and informal caregivers--family members, caregiving friends, homemakers and a variety of health care providers--who collaborate together and with the individual to provide holistic care. Thus, co-ordination, collaboration and communication are essential if this network is to meet the physical, psychological, social and spiritual needs of the dying and their families.

Masculinity ideology among young African American and European American women and men in different regions of the United States.

This is a report of 2 studies. Study 1, a replication of R.F. Levant and R.G. Majors (1997), examined variations in the endorsement of traditional and nontraditional masculinity ideology, by gender and race, among 270 African American and 226 European American young men and women using the Male Role Norms Inventory (MRNI; Levant & Fischer, in press). Although both gender and race differences in masculinity ideology were significant, gender had a larger effect size. Study 2, focused on the effect of residence in different geographic regions of the country, compared the MRNI scores of the more metropolitan Northeastern and Mid-Atlantic sample of the present study with those of the more rural Southern sample used by Levant and Majors. This study found that the effect of geographic place of residence moderates the effect of race on masculinity ideology, which underscores the importance of subcultural variations (e.g., metropolitan vs. rural) within cultural groups defined by race.

The efficacy of a response cost-based treatment package for managing aggressive behavior in preschoolers.

The present study examined the effectiveness of a response cost treatment package for improving the classroom behavior of four aggressive preschoolers. Using a multiple baseline design, teachers implemented the response cost system during the treatment phases of the study. The system required teachers to remove smiley faces contingent on aggressive behavior. Each face loss was accompanied by a reprimand. If the child retained at least one smiley face at the end of the observation period, he was allowed to choose from a list of rewards. Rewards were easily administered at school. The results indicated that the response cost treatment package substantially decreased aggressive behavior and was a highly acceptable classroom treatment to teachers and parents.

The development of the Toddler Behavior Screening Inventory.

The purpose of the present study was to develop the Toddler Behavior Screening Inventory (TBSI) for rapidly assessing maternal reports of toddler behavior problems. The TBSI is a 40-item measure intended for use by pediatricians, psychologists, and other child-care professionals. A group of mothers (n = 312) rated the initial 93-item TBSI in terms of behavior frequency and parental perception of the behavior as problematic. Following item elimination, 40 items were retained due to being both frequent and problematic at all toddler age levels. Data were obtained with a new sample of mothers (n = 581) and showed the TBSI to possess good reliability and validity.

Differential emotions theory: relative contribution of emotion, cognition, and behavior to the prediction of depressive symptomatology in non-referred adolescents.

This study examined the relative contribution of emotions, cognition, and behavior to depressive symptomatology with 80 non-referred adolescents. Differential emotions theory emphasized emotions but pointed to the importance of behavioral and cognitive variables. Subjects completed self-rating scales, theoretically related to depression and differential emotions theory, assessing depressive symptomatology, emotions, automatic dysfunctional thoughts, and activity. Two hierarchical multiple regression models entered the emotional variables first but varied the entry of behavioral and cognitive variables. The findings emphasized the interplay between emotion and behavior, and provided equivocal support for the role of cognition.

I want to live here for rest of my life. The challenge of case management for rural seniors.

The research on long-term care for seniors clearly demonstrates that efforts to integrate urban case management services with elderly people living in rural settings have not been successful. Presenting findings of the Rural Seniors Assisted Living Study conducted in northwestern Ontario, Canada, this article demonstrates the complexity of providing health and social services for seniors living in small rural communities, services that are often vastly different from those provided in urban communities. The article proposes a specialized Rural Case Management approach with rural elderly clients and identifies four intervention roles: providing direct service, consulting extensively with specialists of other disciplines, constructing and supporting natural helping networks, and resource management. The approach also requires that the rural case manager assume a leadership role at the community level in the development of services for seniors. Having a locally based case manager rather that a case manager who travels out to rural areas from an urban center is essential to the success of this rural case management approach. Finally, the article contends that rural case management differs from urban case management by requiring specialized knowledge, skills and educational programs.

Development and validation of the Screen for Adolescent Violence Exposure (SAVE).

Empirical evidence was provided on the utility of the Screen for Adolescent Violence Exposure (SAVE) in assessing adolescent exposure to school, home, and community violence. The SAVE was empirically developed on 1,250 inner-city adolescents, and obtained excellent reliability and validity. Both exploratory and confirmatory factor analyses identified three factors: Traumatic Violence, Indirect Violence, and Physical/Verbal Abuse. The SAVE demonstrated utility in classifying high- and low-violence participants, and correlated significantly with both objective crime data and theoretically relevant constructs (anger, posttraumatic stress symptoms, and internalizing/externalizing problems). Thus, the SAVE provides measurement of the stressor criterion associated with posttraumatic stress disorder, and allows quantification of severity of violence exposure by setting.

Palliative care providers' perspectives on service and education needs.

To obtain the information necessary for coordinated regional program development, we examined (a) the multidisciplinary viewpoint of palliative care service provision and (b) the continuing education needs reported by non-physician service providers. Of 146 surveys distributed to care providers from multiple settings, 135 were returned. Respondents cited these problems: fragmented services, poor pain and symptom control, lack of education for providers, lack of public awareness, problems with the continuity and coordination of care, lack of respite, and lack of hospice beds. Stress management for caregivers, pain management, communication skills, and symptom assessment were rated as priorities in continuing education. Lectures, small group discussions, practicum, and regular medical centre rounds were the preferred learning formats, while costs and staff shortages were cited as educational barriers.